When moving your bowels seems like a feat, what should you do with your feet? (Photo: Courtesy of The Ohio State University Wexner Medical Center)Courtesy of The Ohio State University Wexner Medical Center

When trying to move your bowels and experiencing constipation, do you know squat?

Unless you use an unusually low toilet or have very long praying mantis-like legs, you probably aren’t really squatting when using the porcelain throne, the can, the oval office, the private texting chair, or whatever you want to call that thing that you sit on to poop. But according to a researcher team at The Ohio State University Wexner Medical Center, squatting would be a more natural way to go number 2. That’s why this team, which consisted of Rohan M. Modi, MD, Alice Hinton, PhD, Daniel Pinkhas, DO, Royce Groce, MD, MS, Marty Meyer, MD, Gokulakrishnan Balasubramanian, MD, Edward Levine, MD, and Peter P. Stanich, MD, decided to test the use of a footstool to help people move their stools. The theory behind using such a stool is pretty straightforward. Resting your feet on a stool allows you to further bend your knees and better approximate squatting. Squatting then straightens out your rectum, making it easier for those logs to get through to their destination as explained by the following video:

The team published their results in the Journal of Clinical Gastroenterology. They called the footstool a Defecation Posture Modification Device (DPMD). Try using that term the next time you ask someone for a footstool to help reach for something. The study consisted of having 52 volunteers (average age 29 years old, 40.1% female) go to the bathroom without using the DPMD for 2 weeks and then while using the DPMD for two weeks. At the beginning of the study, 28.8% had reported experiencing “incomplete emptying”, 44.2% ”increased straining”, and 55.8% “blood on their toilet paper” in the previous year. During the study, the researchers counted 1119 bowel movements, not just from one participant but all participants combined, with 735 of these occurring without the use of a footstool and 384 with the footstool. They found that using the footstool was associated with 3.64 times the likelihood of people feeling like they fully emptied their bowels and a 77% reduction in straining. When not using the footstool, study participants on average experienced a 25% increase in bowel movement duration, i.e., longer time on the can which had nothing to do with texting or reading an interesting article.

These seem like promising results from what seems to be a fairly simple fix. Of course, you don’t necessarily have to use a footstool (er, a Defecation Posture Modification Device), to lift your feet. Anything that can get you more in a squatting position may help, like stacks of magazine or a hoverboard. Just don’t use the other kind of stool, which would be really gross. Also, be careful about trying to lift your feet without an object for support. This would not be a standard yoga position.

Such a fix may be a welcome possibility for many. It’s unclear how many people suffer from constipation in silence. When it comes to talking about constipation, you may be inclined to hold it in, feeling that there’s a stigma about such poop talk or that there’s no appropriate time to discuss it (For example, “honey, this view of the Grand Canyon is great, look at that rock formation. Speaking of rocks.”) Of course, not discussing this basic human function can be harmful in many ways.

That’s because constipation can be quite a big deal. It can leave you feeling uncomfortable and cause abdominal pain. When you are on the toilet, not only can you find yourself talking to yourself (“come on now, you can do it” or ”just come out already”), straining like you are trying to launch yourself into orbit can lead to hemorrhoids, tears in your anal region, and falling off the toilet. Pooping is your body’s way of taking out the garbage, so you don’t that process to not work. Inability to adequately poop could potentially contribute to other health problems. Studies have shown that between 2% and 27% of the population suffer chronic constipation, depending on the definition (e.g., frequency) of chronic constipation being used. Not being able to adequately empty your bowels can really leave you pooped out, or rather pooped in may be more appropriate. When you remain constipated long enough, the poop can collect and become rock hard, resulting in a condition called fecal impaction, where your intestines are blocked, full of stool, and swell to a dangerous degree.

Relying on medications such as laxatives is not a good long term solution. They can have side effects, such as disrupting your intestinal function and structure and causing dehydration. They can also interact with other medications and result in you becoming dependent on them While changes in diet such as increasing fiber and fluid intake and getting more physical activity in general can help loosen and move your stools, these don’t always do the trick.

Therefore, this little trick with a footstool or a step stool may be a step in the right direction.